DOCSLIB.ORG

Hypochondriasis: Considerations for ICD-11 Odile A

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Hypochondriasis: Considerations for ICD-11 Odile A Revista Brasileira de Psiquiatria. 2014;36:S21–S27 ß 2014 Associac¸a˜ o Brasileira de Psiquiatria doi:10.1590/1516-4446-2013-1218 UPDATE ARTICLE Hypochondriasis: considerations for ICD-11 Odile A. van den Heuvel,1,2 David Veale,3,4 Dan J. Stein5 1Department of Psychiatry, VU University Medical Center (VUmc), Amsterdam, The Netherlands. 2Department of Anatomy & Neurosciences, VUmc, Amsterdam, The Netherlands. 3Institute of Psychiatry, King’s College London, London, UK. 4Center for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK. 5Department of Psychiatry, University of Cape Town, Cape Town, South Africa. The World Health Organization (WHO) is currently revisiting the ICD. In the 10th version of the ICD, approved in 1990, hypochondriacal symptoms are described in the context of both the primary condition hypochondriacal disorder and as secondary symptoms within a range of other mental disorders. Expansion of the research base since 1990 makes a critical evaluation and revision of both the definition and classification of hypochondriacal disorder timely. This article addresses the considerations reviewed by members of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders in their proposal for the description and classification of hypochondriasis. The proposed revision emphasizes the phenomenological overlap with both anxiety disorders (e.g., fear, hypervigilance to bodily symptoms, and avoidance) and obsessive-compulsive and related disorders (e.g., preoccupation and repetitive behaviors) and the distinction from the somatoform disorders (presence of somatic symptom is not a critical characteristic). This revision aims to improve clinical utility by enabling better recognition and treatment of patients with hypochondriasis within the broad range of global health care settings. Keywords: Hypochondriasis; illness anxiety disorder; obsessive-compulsive and related disorders; definition; classification Introduction caused by medical conditions and that warrant medical evaluation and/or treatment. Certainly, from an evolu- The World Health Organization (WHO) is currently tionary perspective, an appropriate level of anxiety and revising the ICD. The 10th version of the ICD1 was response to somatic alarm symptoms may have adaptive approved in 1990, almost 25 years ago. The development value. However, when concern about health becomes a of ICD-11 requires attention to the relevant historical matter of preoccupation and continuous fear or distress, it background as well as to more recent developments interferes with daily life. in understanding of clinical entities related to illness Individuals with such concerns may meet the diagnos- preoccupation and fear. This article addresses the tic requirements of the DSM-IV-TR5 and ICD-101 diag- question of how hypochondriasis should be described noses of hypochondriasis and hypochondriacal disorder, and classified in the ICD-11, and addresses the con- respectively. Hypochondriasis has negative effects on siderations reviewed by the members of the WHO ICD-11 quality of life, social and occupational functioning, and Working Group on the Classification of Obsessive- health care resource utilization, and is thus an important Compulsive and Related Disorders in their proposal for mental disorder to recognize and treat in clinical practice. the description and classification of this disorder. Although health care practitioners are familiar with those Preoccupation with bodily symptoms and fear of patients who seek reassurance during repeated visits to suffering from a serious disease falls on a continuum health care services, resulting in high health care costs, ranging from a very mild concern about some unusual unnecessary diagnostic interventions, and disturbed bodily sensation or observation to severe preoccupation patient-doctor relationships, hypochondriasis can also and fear or conviction in individuals in whom thoughts and lead to severe avoidance, risking unfavorable delays in actions are centered around the overestimated risk of case of actual diseases. In most patients with hypochon- 2 having or developing a serious, life-threatening illness. driasis, symptoms wax and wane, with acute exacerba- Taxometric studies have empirically confirmed that tions triggered by stressful periods – e.g., due to loss of a anxiety about health is a dimensional rather than a family member, a past experience of actual organic 3,4 categorical construct. Normal expressions of concern disease, and social circumstances, or in response to about health and alertness towards bodily symptoms may hospital and disease-related items in the mass media.6 be a useful response to changes in the body that are Correspondence: Odile A. van den Heuvel, Department of Historical background Psychiatry, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. Hypochondriasis as a psychiatric concept has been the E-mail: [email protected] subject of considerable controversy over the centuries. S22 van den Heuvel et al. Today, hypochondriasis is considered a mental disorder, of self-directed exposure and cognitive change (cognitive but in the 17th century it referred to a common somatic reappraisal) are successful in the reduction of discomfort condition, with the name hypochondria, introduced by and attenuation of the urge to seek reassurance. Hippocrates and literally meaning ‘‘below the cartilage,’’ The long-lasting debate on both the terminology and suggesting the involvement of abdominal organs. The the conceptualization of hypochondriasis is currently transformation of the description over time, with the initial focused on the following issues12: 1) is hypochondriasis reference to a mental condition occurring in the early 19th a distinct primary medical entity or a secondary feature of century, has been described extensively by Noyes.7 other psychopathologies? 2) what are the discriminating Briefly, 17th century authors, still strongly influenced by diagnostic features of hypochondriasis and how can Galen’s views of pathogenesis, related hypochondriasis these be differentiated from normality? and 3) how best to to melancholic personality traits, caused by somatic classify hypochondriasis, taking into account its relation digestive disturbances. Psychological concepts became to somatoform disorders, anxiety disorders, and obses- more prominent in the description of hypochondriasis sive-compulsive and related disorders (OCRD)? Here, we from the late 18th century onward. At that time, it was summarize the existing but limited literature on these thought that a depressive ‘‘morbid’’ state would change issues, as well as recent developments in relation to body awareness, resulting in digestive disturbances. DSM-5, and propose the options for ICD-11. Although attention started to switch from the intestines to the brain in the 19th century, hypochondriasis became The ICD-10 approach to hypochondriasis regarded as a neurosis, i.e., a functional rather than structural disturbance. Fear of serious illness was In the ICD-10 Clinical Descriptions and Diagnostic emphasized as its principal characteristic, digestive Guidelines for mental and behavioral disorders,13 hypo- symptoms were no longer considered as crucial, and chondriacal symptoms are described in the context bodily preoccupation and hypervigilance and abnormal of both the primary condition hypochondriasis and illness behaviors started to receive attention. During as secondary symptoms of a range of other mental this ‘‘physical-to-mental’’ transformation of the concept entities (e.g., delusional disorder and depression). of hypochondriasis, it became one of many mental Hypochondriacal disorder (F45.2) is included in the disorders. The historical review by Noyes, mainly focus- grouping of somatoform disorders. Its main character- ing on the 17th, 18th, and 19th centuries, shows the istics are: 1) the persistent belief in the presence of at influential role of social and cultural factors in shaping the least one serious physical illness underlying the present- description of the disorder over time, and the uncertainty ing symptom(s), even though repeated investigations and about how to classify the disorder in relation to other examinations have identified no adequate physical clinical entities. explanation, or a persistent preoccupation with a pre- Psychodynamic theories of hypochondriasis mainly sumed deformity or disfigurement; and 2) the persistent focused on the role of (unconscious) guilt over sexual refusal to accept the advice and reassurance of several and hostile wishes, fantasies, and feelings that must be different doctors that there is no physical illness or disguised to avoid overwhelming fear of punishment, abnormality underlying the symptoms. Five partially 8 bodily damage (castration), and death. The psychody- overlapping inclusion terms are listed for hypochondriacal namic term hypochondriacal neurosis was adopted by disorder, i.e., body dysmorphic disorder, dysmorphopho- DSM-II, and despite criticism of and controversy about bia, hypochondriacal neurosis, hypochondriasis, and both the relevant terminology and construct, the terms nosophobia, indicating that any of these phenomena hypochondriasis and hypochondriacal disorder persisted should be assigned the diagnosis of hypochondriacal 9 in subsequent revisions of DSM and ICD. disorder. Current concepts of hypochondriasis have been Based on more recent research,2 some aspects related considerably
Load more

Recommended publications
  • Inositol Safety: Clinical Evidences
    European Review for Medical and Pharmacological Sciences 2011; 15: 931-936 Inositol safety: clinical evidences G. CARLOMAGNO, V. UNFER AGUNCO Obstetrics & Gynecology Center, Rome (Italy) Abstract. – Myo-inositol is a six carbon ent required by the human cells for the growth cyclitol that contains five equatorial and one axi- and survival in the culture. In humans and other al hydroxyl groups. Myo-inositol has been classi- species, Myo-inositol can be converted to either fied as an insulin sensitizing agent and it is L- or D-chiro-inositol by epimerases. Early stud- commonly used in the treatment of the Polycys- tic Ovary Syndrome (PCOS). However, despite ies showed that inositol urinary clearance was al- its wide clinical use, there is still scarce informa- tered in type 2 diabetes patients, the next step tion on the myo-inositol safety and/or side ef- was to link impaired inositol clearance with in- fects. The aim of the present review was to sum- sulin resistance (for a review see1). Because of marize and discuss available data on the myo-in- these properties, inositol have been classified as ositol safety both in non-clinical and clinical set- “insulin sensitizing agent”2. tings. The main outcome was that only the highest In the recent years, inositol has found more dose of myo-inositol (12 g/day) induced mild and more space in the reproductive clinical prac- gastrointestinal side effects such as nausea, fla- tice3-6. Indeed, since the main therapy for Poly- tus and diarrhea. The severity of side effects did cystic Ovary Syndrome (PCOS) is the use of in- not increase with the dosage.
    [Show full text]
  • Clinically Significant Avoidance of Public
    Journal of Anxiety Disorders 23 (2009) 1170–1176 Contents lists available at ScienceDirect Journal of Anxiety Disorders Clinically significant avoidance of public transport following the London bombings: Travel phobia or subthreshold posttraumatic stress disorder? Rachel V. Handley a,*, Paul M. Salkovskis a, Peter Scragg b, Anke Ehlers a a King’s College London, Institute of Psychiatry, Department of Psychology, and Centre for Anxiety Disorders and Trauma, London, UK b Trauma Clinic, London, UK ARTICLEI NFO ABSTRA CT Article history: Following the London bombings of 7 July 2005 a ‘‘screen and treat’’ program was set up with the aim of Received 6 March 2008 providing rapid treatment for psychological responses in individuals directly affected. The present study Received in revised form 28 July 2009 found that 45% of the 596 respondents to the screening program reported phobic fear of public transport Accepted 28 July 2009 in a screening questionnaire. The screening program identified 255 bombing survivors who needed treatment for a psychological disorder. Of these, 20 (8%) suffered from clinically significant travel phobia. Keywords: However, many of these individuals also reported symptoms of posttraumatic stress disorder [PTSD]. Terrorist violence Comparisons between the travel phobia group and a sex-matched group of bombing survivors with PTSD Specific phobia showed that the travel phobic group reported fewer re-experiencing and arousal symptoms on the Posttraumatic stress disorder Screening Trauma Screening Questionnaire (Brewin et al., 2002). The only PTSD symptoms that differentiated the groups were anger problems and feeling upset by reminders of the bombings. There was no difference between the groups in the reported severity of trauma or in presence of daily transport difficulties.
    [Show full text]
  • Tic Disorders
    No. 35 May 2012 Tic Disorders A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs. They can be stopped voluntarily for brief periods. Sounds that are made involuntarily (such as throat clearing, sniffing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life. The most common tic disorder is called "transient tic disorder" and may affect up to 10 percent of children during the early school years. Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Transient tics go away by themselves. Some may get worse with anxiety, tiredness, and some medications. Some tics do not go away. Tics which last one year or more are called "chronic tics." Chronic tics affect less than one percent of children and may be related to a special, more unusual tic disorder called Tourette's Disorder. Children with Tourette's Disorder have both body and vocal tics (throat clearing). Some tics disappear by early adulthood, and some continue. Children with Tourette's Disorder may also have problems with attention, and learning disabilities. They may act impulsively, and/or develop obsessions and compulsions. Sometimes people with Tourette's Disorder may blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them.
    [Show full text]
  • Specific Phobias
    Specific Phobias Fact sheet 38 Fact sheet 38 What is a speciFic phobia? Concern or fear about certain situations, activities, animals or objects is not uncommon. Many people feel anxious when faced with a snake or spider, or travelling by plane. Fear is a rational response in certain situations. However, some people react to objects, activities or situations (the phobic stimulus) by imagining or irrationally exaggerating the danger, resulting in panic, fear or terror that is out of proportion to the actual threat. Sometimes, even the thought of, or simply seeing the phobic stimulus on television, is enough to cause a reaction. These types of excessive reactions may be indicative of a Specific Phobia. People with Specific Phobias are often well aware that their fears are exaggerated or irrational, but feel that their anxious reaction is automatic or they are not able to control it. When exposed to the phobic stimulus, anxiety can reach excessive levels. Specific Phobias are often associated with panic attacks, during which the person experiences and is overwhelmed by physical sensations that may include a pounding heart, choking, nausea, faintness, dizziness, chest pain, hot or cold flushes and perspiration. For more information on panic sttacks, see beyondblue Fact sheet – 36 panic Disorder. Specific Phobias are generally divided into the following categories: signs anD symptoms • Animal type: fear that relates to animal or insects A person may have a Specific Phobia if he/she: (e.g. fear of dogs or spiders). • Has a persistent fear that is excessive and unreasonable • Natural-Environment type: a fear associated with the in relation to a specific object, activity or situation, such as natural environment (e.g.
    [Show full text]
  • Anxiety Disorders in Children Revised 2020
    Information about: Anxiety Disorders in Children Revised 2020 Vermont Family Network 600 Blair Park Road, Ste 240 Williston, VT 05495 1-800-800-4005 www.VermontFamilyNetwork.org Introduction According to The Child Mind Institute, “Children with anxiety disorders are overwhelmed by feelings of intense fear or worry that they are out of proportion to the situation or thing that triggers them. These emotional fears can be focused on separating from parents, physical illness, performing poorly, or embarrassing themselves. Or they can be attached to specific things, like dogs or insects or bridges.” We hope that this will give you a greater understanding of anxiety disorders and the ways that parents and professionals can support children at home, in school, and in the community. We have selected information from various sources and provided internet links when possible. The information we have presented was used by permission from various sources. We have provided links for you to find more, in-depth information at their sites. Contents Title Page Anxiety Disorders in Children and Adolescents 2 Additional Treatments and Guidance 2 The Anxious Child 3 Anxiety Quick Fact Sheet for School Personnel & 4 Parents/Guardians Children Who Won’t Go to School (Separation Anxiety) 6 Managing Anxiety with Siblings 6 Panic Disorder in Children and Adolescents 7 Parenting Tips for Anxious Kids 8 Getting Linked (local resources) 9 Advocating for Your Child: 25 Tips for Parents 10-12 Resources 13 Anxiety Disorders in Children and Adolescents What Are Anxiety Disorders? According to The National Alliance on Mental Illness (NAMI)*, “Anxiety disorders are the most common mental health concern in the United States.
    [Show full text]
  • SOMATIC SYMPTOM, BODILY DISTRESS and RELATED DISORDERS in CHILDREN and ADOLESCENTS 2019 Edition
    IACAPAP Textbook of Child and Adolescent Mental Health Chapter CHILD PSYCHIATRY & PEDIATRICS I.1 SOMATIC SYMPTOM, BODILY DISTRESS AND RELATED DISORDERS IN CHILDREN AND ADOLESCENTS 2019 edition Olivia Fiertag, Sharon Taylor, Amina Tareen & Elena Garralda Olivia Fiertag MBChB, MRCPsych, PGDip CBT Consultant Child and Adolescent Psychiatrist. Honorary Clinical Researcher, HPFT NHS Trust & collaboration with Imperial College London, UK Conflict of interest: none declared Sharon Taylor BSc, MBBS, MRCP, MRCPsych, CASLAT, PGDip Consultant Child and Adolescent Psychiatrist CNWL Foundation NHS Trust & Honorary Senior Clinical Lecturer Imperial College London, UK. Joint Program Director, St Mary’s Child Sick Girl. Psychiatry Training Scheme Christian Krogh, Conflict of interest: none (1880/1881) National declared Gallery of Norway This publication is intended for professionals training or practicing in mental health and not for the general public. The opinions expressed are those of the authors and do not necessarily represent the views of the Editor or IACAPAP. This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws of their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all dosages and unwanted effects are mentioned. Organizations, publications and websites are cited or linked to illustrate issues or as a source of further information. This does not mean that authors, the Editor or IACAPAP endorse their content or recommendations, which should be critically assessed by the reader.
    [Show full text]
  • Monosymptomatic Hypochondriacal Psychosis (Somatic Delusional Disorder): a Report of Two Cases
    SCIENTIFIC LETTER | http://dx.doi.org/10.4314/ajpsy.v16i2.11 Afr J Psychiatry 2013;16:87-91 Monosymptomatic Hypochondriacal Psychosis (somatic delusional disorder): A report of two cases Historically, the term Monosymptomatic Hypochondriacal abusing any psychoactive substances and was said to be well Psychosis (MHP) was first used by Munro in 1978. 1 MHP is adjusted premorbidly. Based on history and examination, she classified as a somatic type of delusional disorder in DSM- IV 2 was managed as a case of paranoid schizophrenia (with and is defined as an erroneous conviction of bodily disease, olfactory reference syndrome) and was treated with abnormality or alteration. 3 It includes delusional beliefs about haloperidol 15mg daily to which she responded positively bodily sensations or functions; such as feeling malodorous, after one week. As of when she was seen last in the out-patient being infected by parasites, having dysmorphic features, or clinic, she remained stable on maintenance dose of that a certain organ is no longer functioning. 4 MHP has been haloperidol 5mg nocte. divided into 4 main categories: Delusions of infestation Mr B was a 45 year old married, Christian saw-miller who (including parasitosis); delusions of dysmorphophobia, such presented with a year and a half history of the feeling that as of misshapenness, personal ugliness, or exaggerated size insects were crawling all over his body, a mucus substance of body parts (this seems closest to that of body dysmorphic entering his eyes and a three month history of inadequate disorder); delusions of foul body odours or halitosis or sleep. The insects were of different sizes and shapes (cubiodal delusional bromosis (also known as olfactory reference and cylindrical).
    [Show full text]
  • Chapter 05- Mental, Behavioral and Neurodevelopmental Disorders
    Chapter 5 Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Includes: disorders of psychological development Excludes2: symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99) This chapter contains the following blocks: F01-F09 Mental disorders due to known physiological conditions F10-F19 Mental and behavioral disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders F30-F39 Mood [affective] disorders F40-F48 Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors F60-F69 Disorders of adult personality and behavior F70-F79 Intellectual disabilities F80-F89 Pervasive and specific developmental disorders F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence F99 Unspecified mental disorder Mental disorders due to known physiological conditions (F01-F09) Note: This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved. F01 Vascular dementia
    [Show full text]
  • Somatoform Disorders – September 2017
    CrackCast Show Notes – Somatoform Disorders – September 2017 www.canadiem.org/crackcast Chapter 103 – Somatoform disorders Episode overview 1. List 5 somatic symptom and related disorders 2. List 5 common presentations of conversion disorders 3. List 6 ddx of somatic symptom disorder Wisecracks 1. List 6 organic diseases that may be mistaken for somatoform disorders 2. Describe the treatment goals of somatoform disorders Somatoform disorders as a diagnosis has been eliminated from the DSM-5! The patient with functional neurological symptom disorder, what was termed conversion disorder previously, requires a careful and complete neurological examination. Rather than miss the subtle presentation of a neurological disorder, it may be appropriate to perform imaging and obtain neurological and psychiatric consultation. Do not assume that the patient with neurological deficits has a psychiatric disorder. Success with the SSD patient depends on establishing rapport with the patient and legitimizing their complaints to avoid a dysfunctional physician-patient interaction. • Avoid telling the SSD patient “it is all in your head” or “there is nothing wrong with you.” These patients are very sensitive to the idea that their suffering is being dismissed. • A useful approach is to discuss recent stressors with the patient and suggest to them that at times our bodies can be smarter than we are, telling us with physical symptoms that we need assistance. This approach alone may transform the ED visit from a standoff between physician and patient, to a grateful patient who develops greater insight and is amenable to referral. • Avoid prescribing unnecessary or addictive medications to the SSD patient. • If you suspect a diagnosis of SSD, refer the patient to primary care or psychiatry for further evaluation and treatment.
    [Show full text]
  • Comparison of Memory Function and MMPI-2 Profile Between Post-Traumatic Stress Disorder and Adjustment Disorder After a Traffic Accident
    Original Article http://dx.doi.org/10.9758/cpn.2014.12.1.41 pISSN 1738-1088 / eISSN 2093-4327 Clinical Psychopharmacology and Neuroscience 2014;12(1):41-47 Copyrightⓒ 2014, Korean College of Neuropsychopharmacology Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident Sung-Man Bae1, Myoung-Ho Hyun3, Seung-Hwan Lee1,2 1Department of Psychiatry, Inje University Ilsan Paik Hospital, 2Clinical Emotion and Cognition Research Laboratory, Goyang, 3Department of Psychology, Chung-Ang University, Seoul, Korea Objective: Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. Methods: Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck’s Depression Inventory were administered. Results: There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 clas- sified significantly PTSD and AD group. Conclusion: Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD. KEY WORDS: Diagnosis, Differential; Post-traumatic stress disorders; Adjustment disorders; Memory deficits; MMPI-2. INTRODUCTION Previous studies have reported that memory impair- ment is associated with PTSD symptoms.11-14) Several Post-traumatic stress disorder (PTSD) can be diag- studies have shown a significant difference in verbal nosed only if the accident (trauma) is severe and psycho- memory ability between people with PTSD and control logical distress is extreme.
    [Show full text]
  • Specific Phobia of Illness:: Search for a New Subtype
    Anxiety Disorders 18 (2004) 531–545 Specific phobia of illness: Search for a new subtype Russell Noyes Jr.*, Caroline P. Carney, Douglas R. Langbehn Departments of Biostatistics, Psychiatry and Internal Medicine, The University of Iowa Roy J. and Lucille A. Carver Colleges of Medicine and Public Health, Iowa City, IA 52242-1000, USA Received 13 December 2002; received in revised form 2 June 2003; accepted 20 June 2003 Abstract Specific phobia of illness makes its appearance in DSM-IVas a new diagnostic subtype, separate from hypochondriasis. A review of the literature indicates that, while there is some support for this new category, studies have not as yet been done that could provide validation. Illness phobia appears to be a significant problem; it is prevalent in the general population and is associated with distress and impairment, including interference with medical care. It appears to be associated with older age, physical illness, and female gender. Group comparisons are needed showing that persons with this phobia can be distinguished from hypochondriasis on the basis of these and other demographic and illness features. We outline a research agenda for demonstrating this separation. # 2003 Elsevier Inc. All rights reserved. Keywords: Specific phobia; Illness phobia; Hypochondriasis; Classification Illness phobia first appears in DSM-IV under the heading of specific phobia, other type (American Psychiatric Association, 1994). There it is defined as an unreasonable fear of contracting a disease and distinguished from hypochon- driasis. According to this classification, illness phobics fear developing a disease they do not have, whereas persons with hypochondriasis are preoccupied with a disease they believe is already present (American Psychiatric Associa- tion, 1991).
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines
    ICD-10 ThelCD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines | World Health Organization I Geneva I 1992 Reprinted 1993, 1994, 1995, 1998, 2000, 2002, 2004 WHO Library Cataloguing in Publication Data The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. 1.Mental disorders — classification 2.Mental disorders — diagnosis ISBN 92 4 154422 8 (NLM Classification: WM 15) © World Health Organization 1992 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]